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Suggest Remedy For Abdominal Bloating, Constipation And Acid Reflux
Question: I am 35yr old woman. I have mild hepatomegaly. I take Setraline 100 for depression. Having Amenorrhea for last 2 months. Prolactin level 173. Not pregnant. Doctor prescribed Cabgolin 0.5mg once a week. Since taking cabergoline I am having extreme bloating, intestinal gas & constipation. Doctor prescribed Looz syrup and Pantocid DSR. I drink 3L water daily,eat vegetables, avoid fried food, no alcohol. Seeking 2nd opinion...pls advise. Thanks.
Brief Answer:
Drug induced side effects.
Detailed Answer:
Hi & Welcome.
I can understand your concern.
After having gone through the history and the prescribed medications I am of the opinion the symptoms of difficulty having a bowel movement (constipation), extreme bloating, stomach acidity and belching are the side effects of the drug Cabgolin (Cabergoline).
Normal level of Prolactin in non-pregnant females: 2 to 29 ng/mL.
Cabergoline is commonly prescribed in the treatment of amenorrhea, galactorrhea (excessive milk production) caused by increased levels of hormone Prolactin.
The recommended dosage of Cabergoline tablets for initiation of therapy is 0.25 mg twice a week. Dosage may be increased by 0.25 mg twice weekly up to a dosage of 1 mg twice a week according to serum Prolactin level.
It seems to me the dosage prescribed is slightly high and that could have caused the side effects which are treated by Looz syrup (Lactulose) for constipation, Pantocid DSR for the symptoms of belching, bloating and stomach acidity.
I, therefore advise you to consult your treating doctor to review the dosage of Cabgolin.
Mild hepatomegaly could be due to fatty liver, which can be reduced by certain lifestyle changes like avoiding fatty meals, eating home cooked foods, increasing the intake of fruits and vegetables.
Hope the suggestions given above would be of great help in reducing the symptoms.
Best regards.
Drug induced side effects.
Detailed Answer:
Hi & Welcome.
I can understand your concern.
After having gone through the history and the prescribed medications I am of the opinion the symptoms of difficulty having a bowel movement (constipation), extreme bloating, stomach acidity and belching are the side effects of the drug Cabgolin (Cabergoline).
Normal level of Prolactin in non-pregnant females: 2 to 29 ng/mL.
Cabergoline is commonly prescribed in the treatment of amenorrhea, galactorrhea (excessive milk production) caused by increased levels of hormone Prolactin.
The recommended dosage of Cabergoline tablets for initiation of therapy is 0.25 mg twice a week. Dosage may be increased by 0.25 mg twice weekly up to a dosage of 1 mg twice a week according to serum Prolactin level.
It seems to me the dosage prescribed is slightly high and that could have caused the side effects which are treated by Looz syrup (Lactulose) for constipation, Pantocid DSR for the symptoms of belching, bloating and stomach acidity.
I, therefore advise you to consult your treating doctor to review the dosage of Cabgolin.
Mild hepatomegaly could be due to fatty liver, which can be reduced by certain lifestyle changes like avoiding fatty meals, eating home cooked foods, increasing the intake of fruits and vegetables.
Hope the suggestions given above would be of great help in reducing the symptoms.
Best regards.
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
Thank you for your speedy response!
My queries are as follows:
1) For my liver health, I am following a diet of homecooked meals, comprising brown bread/rice/chapattis, egg whites, vegetables, dal and a little chicken. Is that good enough?
2) The USG of my whole abdomen showed a small uterine fibroid, which my doctor didn't consider significant. Is that a factor in my Amenorrhea?
3) I have been taking Sertraline (SSRI antidepressant) for a year; could it be a factor in Amenorrhea? Can it react with Cabgolin?
4) I also take 50 mcg Thyronorm daily for Hypothyroidism. Can this react with any of the medicines discussed?
5) How long do I need to take the Cabgolin? I have taken 3 doses so far over 3 weeks. When should I test Prolactin again?
6) Will the mentioned medicines react with the following daily supplements I take:
(i) Flaxseed Oil
(ii) Gemcal Plus (contains Calcium carbonate, Zinc, Boron, Calcitriol, Magnesium, Mecobalamin and Vitamin K7)
7) Can I continue to use Cannabis occasionally? I have been a regular user for many years, without having any lung issues or psychological problems. My depression is since childhood, not caused by Cannabis, in fact Cannabis helps alleviate the depression.
8) Could there be a possibility of a Pituitary Tumour/Prolactinoma?
Sorry to bother you again with so many questions!
And thanks again for all the help. :-)
My queries are as follows:
1) For my liver health, I am following a diet of homecooked meals, comprising brown bread/rice/chapattis, egg whites, vegetables, dal and a little chicken. Is that good enough?
2) The USG of my whole abdomen showed a small uterine fibroid, which my doctor didn't consider significant. Is that a factor in my Amenorrhea?
3) I have been taking Sertraline (SSRI antidepressant) for a year; could it be a factor in Amenorrhea? Can it react with Cabgolin?
4) I also take 50 mcg Thyronorm daily for Hypothyroidism. Can this react with any of the medicines discussed?
5) How long do I need to take the Cabgolin? I have taken 3 doses so far over 3 weeks. When should I test Prolactin again?
6) Will the mentioned medicines react with the following daily supplements I take:
(i) Flaxseed Oil
(ii) Gemcal Plus (contains Calcium carbonate, Zinc, Boron, Calcitriol, Magnesium, Mecobalamin and Vitamin K7)
7) Can I continue to use Cannabis occasionally? I have been a regular user for many years, without having any lung issues or psychological problems. My depression is since childhood, not caused by Cannabis, in fact Cannabis helps alleviate the depression.
8) Could there be a possibility of a Pituitary Tumour/Prolactinoma?
Sorry to bother you again with so many questions!
And thanks again for all the help. :-)
Brief Answer:
Continue lifestyle changes for the enlarged liver
Detailed Answer:
Hi & Welcome back.
Thanks for your reply and the compliments.
Following are the clarifications for your queries.
1. The diet taken by you is good for your liver problem
2. Uterine fibroid is not responsible for the amenorrhea
3 & 4. Sertraline can cause amenorrhea as its side effect.However, there is no documented interactions between Cabergoline, Sertraline or Thyronorm
5. It should be taken for 4-6 weeks, then the Prolactin level is measured
6. There is no such interactions reported between the mentioned nutritional supplements.
7. Use of Cannabis is not allowed
8. Yes, the possibility of pituitary adenoma producing Prolactin should be ruled out
Hope I could answer your query.
Best regards.
Continue lifestyle changes for the enlarged liver
Detailed Answer:
Hi & Welcome back.
Thanks for your reply and the compliments.
Following are the clarifications for your queries.
1. The diet taken by you is good for your liver problem
2. Uterine fibroid is not responsible for the amenorrhea
3 & 4. Sertraline can cause amenorrhea as its side effect.However, there is no documented interactions between Cabergoline, Sertraline or Thyronorm
5. It should be taken for 4-6 weeks, then the Prolactin level is measured
6. There is no such interactions reported between the mentioned nutritional supplements.
7. Use of Cannabis is not allowed
8. Yes, the possibility of pituitary adenoma producing Prolactin should be ruled out
Hope I could answer your query.
Best regards.
Above answer was peer-reviewed by :
Dr. Raju A.T
Thank you sooo much for your patience and detailed reply.
Just 2 final queries:
1) In your reply, did you mean Pituitary Tumour should NOT be ruled out? If so, then how should I test for tumour?
2) How will I determine whether amenorrhea is due to Sertraline? This is important to find out, because if Sertraline is actually the cause then Cabgolin will not work until I stop taking Sertraline and switch to another SSRI. So how to test the cause of amenorrhea/high Prolactin?
That's all. And I am sad to know that Cannabis is not allowed...I enjoy it very much. :-(
Thanks again for your kind support and help! :-)
Warm regards,
Jyotismita
Just 2 final queries:
1) In your reply, did you mean Pituitary Tumour should NOT be ruled out? If so, then how should I test for tumour?
2) How will I determine whether amenorrhea is due to Sertraline? This is important to find out, because if Sertraline is actually the cause then Cabgolin will not work until I stop taking Sertraline and switch to another SSRI. So how to test the cause of amenorrhea/high Prolactin?
That's all. And I am sad to know that Cannabis is not allowed...I enjoy it very much. :-(
Thanks again for your kind support and help! :-)
Warm regards,
Jyotismita
Brief Answer:
The pituitary adenoma should be ruled out.
Detailed Answer:
Dear Jyotismita,
Hi & Welcome back.
Thanks for your reply and the compliments.
Here are the clarifications for your queries:
1. In my suggestion made earlier, I had stated that the POSSIBILITY OF PITUITARY ADENOMA (TUMOUR) SHOULD BE RULED OUT.
Since pituitary adenoma can be associated with increased production of Prolactin resulting in hyperprolactinemia which can cause amenorrhea, galactorrhea (increased milk production) & infertility.
2. Magnetic resonance imaging (MRI) is the most sensitive test for detecting pituitary tumors and determining their size. Computerized tomography (CT) scan also gives an image of the pituitary but is less precise than the MRI.
Sertraline (selective serotonin re-uptake inhibitor) an antidepressant may cause amenorrhea as its side effect in some patients, but does not increase the Prolactin levels.
Cannabis or Marijuana is generally a drug of abuse, has its own adverse impact on health. There are other means of getting enjoyment, get your self involved in some social or XXXXXXX activities, have regular exercise, & religious activities.
Hope I have clarified your concerns.
Once again, I wish you best of your health.
Take care.
Kindly rate the answers before closing the discussion.
The pituitary adenoma should be ruled out.
Detailed Answer:
Dear Jyotismita,
Hi & Welcome back.
Thanks for your reply and the compliments.
Here are the clarifications for your queries:
1. In my suggestion made earlier, I had stated that the POSSIBILITY OF PITUITARY ADENOMA (TUMOUR) SHOULD BE RULED OUT.
Since pituitary adenoma can be associated with increased production of Prolactin resulting in hyperprolactinemia which can cause amenorrhea, galactorrhea (increased milk production) & infertility.
2. Magnetic resonance imaging (MRI) is the most sensitive test for detecting pituitary tumors and determining their size. Computerized tomography (CT) scan also gives an image of the pituitary but is less precise than the MRI.
Sertraline (selective serotonin re-uptake inhibitor) an antidepressant may cause amenorrhea as its side effect in some patients, but does not increase the Prolactin levels.
Cannabis or Marijuana is generally a drug of abuse, has its own adverse impact on health. There are other means of getting enjoyment, get your self involved in some social or XXXXXXX activities, have regular exercise, & religious activities.
Hope I have clarified your concerns.
Once again, I wish you best of your health.
Take care.
Kindly rate the answers before closing the discussion.
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Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
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